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Urgent! Credentialing Coordinator Job Opening In Farmers Branch Texas – Now Hiring ICONMA, LLC

Credentialing Coordinator



Job description

Our Client, a Healthcare company, is looking for a Credentialing Coordinator for their Farmers Branch, TX location.

 

Responsibilities:


  • The Credentialing Coordinator role will be responsible for ensuring all providers have the necessary requirements and are approved to participate in the application client health plans.

    S/He will maintain strong cross-departmental relationships with Recruiting, Production, and Education This role will report to our Manager of Credentialing.

  • Review and screen initial and reappointment credentialing applications for completeness, accuracy, and compliance with federal, state, local, and NCQA regulations, guidelines, policies, and standards.

    Conducts primary source verification, collects and validates documents to ensure accuracy of all credentialing elements; assesses completeness of information and qualifications relative to credentialing standards and Client criteria, while maintaining the confidentiality of all protected health information that may be accessed.

    Identifies analyzes and resolves extraordinary information, discrepancies, time gaps, and other idiosyncrasies that could adversely impact the ability to credential and enroll practitioners; discovers and conveys problems to Credentialing Manager/Supervisor/Director.

    Monitors files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies; prepares and provides information to internal and external customers as appropriate.

    Enters, updates, and maintains data from provider applications into the credentialing database, focusing on accuracy and interpreting or adapting data to conform to defined data field uses and in accordance with internal policies and procedures.

    Prepares, issues, electronically tracks, and follows up on appropriate verifications for efficient, high-volume processing of individual applications in accordance with applicable credentialing standards, established procedural guidelines, and strict timelines.

    Communicates clearly with providers, internal/external clients, and all Client  staff as needed to provide timely responses upon request on day-to-day credentialing issues as they arise.

    Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of the latest developments to enhance understanding of various regulations and legislation of the healthcare industry and assist with special projects on an as-needed basis.


 

Requirements:


  • Successful work experience in a credentialing role, NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS) or within 2 years of eligibility to certify (Preferred), CAQH Experience (Preferred), MD Staff Experience (Preferred), and Google Suites Experience (Preferred).

  • Level II (3-5 Years)


 

Why Should You Apply?


  • Health Benefits

  • Referral Program

  • Excellent growth and advancement opportunities


 

As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.

 


Required Skill Profession

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